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Lawsuit for a Misread of ED Ultrasound? Not Likely
No lawsuits to date for missed findings
Given the fact that most emergency medicine residencies now include ultrasound in their training, and the use of ultrasound in EDs is clearly increasing, one obvious liability risk involves misreads of ultrasound examinations performed in the ED.
"People are really afraid of this, but should not be, for several reasons." says Michael Blaivas, MD, RDMS , vice president of Bear, DE-based Emergency Ultrasound Consultants and director of emergency ultrasound at Northside Hospital in Atlanta, GA.
Blaivas notes that everyone misreads imaging studies occasionally. "Radiologists are sued for misreading X-rays, MRIs, CTs and ultrasounds all the time," says Blaivas. "I have been an expert in about ten cases now where radiology misread very simple ultrasound examinations with very obvious findings. It will happen to clinicians also, one day."
However, according to the latest published study on the topic, there were no lawsuits filed against ED physicians for missing something on ultrasound as of 2007 in state or federal courts. 1
"There were however, three known lawsuits filed alleging emergency physicians should have performed a point-of-care ultrasound to catch something," says Blaivas. These involved two abdominal aortic aneurysms (AAAs), with one case lost by the ED physician and one that wasn't resolved, and an ectopic pregnancy case that settled out of court.
Focused use of ultrasound "leads to very safe practice," says Blaivas. "[ED physicians] find with some experience, they are better than radiologists at the narrow applications they are performing. This is because most radiologists now get very little training in residency in ultrasound, and often have no interest in it."
Examples include point-of-care AAA evaluation, a pelvic ultrasound to determine if an intrauterine pregnancy is present, and a simple focused assessment with sonography in trauma (FAST) examination to see if there is fluid present in the abdomen of an unstable patient.
"Other procedures, such as thoracentesis and paracentesis, should be done with...